NEW MEMBER APPLICATION

Contact Information

Please provide the following contact information for your NIA Membership.

First Name *

Last Name *

Email *

Phone *

Business Name *

Business Category *

Business Website *

Referred By: *

NIA Group (Choose one) *

Birth Date (We are only interested in celebrating YOU every year. Not knowing your actual age. Please select 2024 as your Year.) *

Mailing Information

Address *

City *

State *

Postal code *

NIA Membership Plans

There is an initial application fee of $200 that covers your background check, personality profile, intro video and hosted profile page. Once the fee is submitted it is nonrefundable.

There are two membership plans. Membership is an annual commitment.

>> $185 monthly for 12 payments

>> $1995 payment annually

You will sign the NIA Member Agreement in the next step.

Fee *

Initial Application Fee

$200